Malaria

Resident – A donor who has ever been present in a malaria risk area, (or areas), for a continuous period of 6 months or more (at any point in their lifetime)

Visitor – A donor who has visited or travelled through a malaria risk area, (or areas), within the past 12 months,

Unexplained febrile illness – A donor who had undiagnosed fever (that could have been malaria) while present in, or within four months of leaving, a malaria risk area.

Previous diagnosis of malaria – A donor who previously had a confirmed diagnosis of malaria, at any point in their lifetime.

Malaria risk area – Risk area for country as defined by the GDRI

MAT: Malarial Antibody Test

NAT: Nucleic Acid Test (for malaria)

Must not donate (if no testing is available):
Applies to all groups as defined above

1a) Previous Malaria: If more than 4 months have passed since anti-malaria therapy has been completed and symptoms caused by malaria have resolved, obtain a blood sample for MAT and NAT test. See information below in this section.

1b) Unexplained Febrile illness:

If less than 4 months from the date of recovery of symptoms of unexplained febrile illness that could have been malaria: Obtain a blood sample for MAT and NAT. See information below in this section.

If more than 4 months from the date of recovery of symptoms of unexplained febrile illness that could have been malaria: Obtain a blood sample for MAT and NAT. If MAT negative, NAT is not required to release tissues. See information below in this section.

1c) Resident:

If less than 4 months since date last present in a malaria risk area:  Obtain a blood sample for MAT and NAT. See information below in this section.

If more than 4 months since date last present in a malaria risk area: Obtain a blood sample for MAT and NAT. If MAT negative, NAT is not required to release tissues. See information below in this section.

1d) Visitor:

If less than 4 months since return: Obtain a blood sample for MAT and NAT. See information below in this section.

If more than 4 and less than 12 months since return: Obtain a blood sample for MAT and NAT. If MAT negative, NAT is not required to release tissues. See information below in this section.

If more than 12 months since return: testing not required, accept

NB.  Please consider T. cruzi or a tropical virus risk if the area is also identified as a risk area for these infections

The results of MAT and NAT tests must be reviewed as a part of donor medical clearance to determine the suitability of tissues for clinical use. If the exposure event is more than four months prior to donation, and MAT is negative, NAT is not required. If the exposure event is less than four months prior to donation, NAT must be done and shown to be negative, irrespective of MAT results. For donors with a history of malaria where treatment was completed and symptoms have resolved at least four months prior to donation, if MAT is negative, NAT is not required. In case of positive MAT results with a confirmed negative NAT test, a risk assessment can be performed for accepting tissues for clinical release after seeking expert opinion.

2. If tissue will be sterilized by irradiation post-donation:
Accept – MAT and NAT testing not required.

3. Eyes
Accept for corneas only – MAT and NAT testing not required.

Geographical Disease Risk Index for countries with a current endemic malaria risk.

Symptoms and signs of possible malaria include: fever, flu-like illness, (including shaking chills, headache, muscle aches, and tiredness), anaemia, jaundice, nausea, vomiting, diarrhoea and cough.

SaBTO Guidance confirms that irradiation of the tissue can be allowed as an alternative to malaria antibody testing.

As corneas are avascular there is not considered to be a risk of transmitting protozoal infections.

Some countries have malaria as well as tropical viral risk. Both risks have to be considered if the donor had symptoms after travel or stay.

This guidance was updated based on advice from the SACTTI parasitology sub-group.